Giant cell tumor (GCT) is a benign tumor that originates from undifferentiated mesenchymal cells of the bone marrow. The cranium as well as temporal bone is a rare location for GCTs. Despite its benign nature, GCT may be locally aggressive and has the potential to recur locally. Furthermore, GCT may give rise to pulmonary metastases (~1%) in addition to causing local bone destruction. Surgical excision is the treatment of choice for patients with GCT. We describe the case of a 56-year-old female who presented with headache and hearing loss with extensive GCT, which originated in the squamous part of the temporal bone and extended into the left mandibular fossa and middle ear. She was treated by total resection of the tumor using left temporal craniotomy approach. In this article, we present a case of temporal bone GCT with its clinical features as well as a review of the related literature.